Question: We are transporting a patient from a small hospital without a CT scanner to a larger hospital with a CT scanner but not a Stroke Centre. Our patient is an obvious stroke patient…slurred speech for over 1 day, but is getting better and no other issues…stable, but still with slurred speech (does not meet Stroke Protocol as onset over 24hrs).

What should we do should this patient become worse enroute to the CT capable hospital? Say his slurred speech becomes worse or he shows other signs and symptoms? Is this considered a “new onset” or a continuation of his current CVA/TIA? If “new onset” I would think he now meets the Stroke Protocol and should be diverted to the Stroke Centre? Could you please clarify?